MEDICARE: HYE JULIE KIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202011366	VA

General Provider Information

NPI Number	:	1588964654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HYE JULIE KIM

Provider Business Mailing Address
First Line	:	4215 CHESHIRE STATION PLZ
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-2217
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4215 CHESHIRE STATION PLZ
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-2217
Country	:	US
Telephone Number	:	703-590-8021
Fax Number	:	703-590-6702

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2010
Last Update Date	:	10/23/2010

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Directions to “ HYE JULIE KIM ” Practice Location

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